<!DOCTYPE html>
<!-- saved from url=(0055)http://twitter.github.com/bootstrap/examples/fluid.html -->
<html lang="en"><head><meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
    <meta charset="utf-8">
    <title>Sample Registration Page</title>
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <meta name="description" content="">
    <meta name="author" content="">
  <script type="text/javascript" src="js/jquery-1.8.2.min.js"></script>

    <!-- Le styles -->
    <link href="./css/bootstrap.css" rel="stylesheet">
    <style type="text/css">
      body {
        padding-top: 60px;
        padding-bottom: 40px;
      }
      .sidebar-nav {
        padding: 9px 0;
      }
    </style>

    <!-- HTML5 shim, for IE6-8 support of HTML5 elements -->
    <!--[if lt IE 9]>
      <script src="http://html5shim.googlecode.com/svn/trunk/html5.js"></script>
    <![endif]-->
  </head>

  <body>

    <div class="navbar navbar-inverse navbar-fixed-top">
      <div class="navbar-inner">
        <div class="container-fluid">
          <a class="btn btn-navbar" data-toggle="collapse" data-target=".nav-collapse">
            <span class="icon-bar"></span>
            <span class="icon-bar"></span>
            <span class="icon-bar"></span>
          </a>
          <a class="brand" href="#">Project name</a>
          <div class="nav-collapse collapse">
            <p class="navbar-text pull-right">
              Logged in as <a href="http://twitter.github123.com/bootstrap/examples/fluid.html#" class="navbar-link">Username</a>
            </p>
            <ul class="nav">
              <li class="active"><a href="http://twitter.github123.com/bootstrap/examples/fluid.html#">Home</a></li>
              <li><a href="http://twitter.github123.com/bootstrap/examples/fluid.html#about">About</a></li>
              <li><a href="http://twitter.github123.com/bootstrap/examples/fluid.html#contact">Contact</a></li>
            </ul>
          </div><!--/.nav-collapse -->
        </div>
      </div>
    </div>

    <div class="container-fluid">
      <div class="row-fluid">
        <div class="span3">
          <div class="well sidebar-nav">
            <ul class="nav nav-list">
              <li class="nav-header">User Management</li>
              <li ><a href="login.html">Home</a></li>
              <li><a href="#">Show All users</a></li>
              <li class="active"><a href="#">Register</a></li>
              <li ><a href="#">Edit User</a></li>
              <li><a href="#">Logout</a></li>
           
            </ul>
          </div><!--/.well -->
        </div><!--/span-->
        <div class="span9">
          <!--<div class="hero-unit">
            <p>Hello put the messsage here.</p>
          </div> -->
          <div class="row-fluid">
            <div class="span11">
<!-----START INCLUDE PHP PAGES HERE ------->
<center><h3>Please fill the details below to complete your registration...</h3></center>
    <hr>
<form name="users" method="post" action="" class="form-horizontal" >

    <table border="0" cellpadding="5">

      <tbody>

        <tr>
          <td align="right" width="40%">Name :</td>
          <td><input type="text" name="name" value="" placeholder="My name is" required/></td>
        </tr>

        <tr>
          <td align="right">Email :</td>
          <td><input type="email" name="email" placeholder="My email id is" required/></td>
        </tr>

        <tr>
          <td align="right">Password :</td>
          <td><input type="password" name="password" value="" placeholder="My password is" required/></td>
        </tr>

        <tr>
          <td align="right">Confirm Password :</td>
          <td><input type="password" value="" placeholder="Retype password" required/></td>
        </tr>

        <tr>
          <td align="right">Gender :</td>
          <td>
          <label class="radio inline" style="margin-left :15px;"><input name="gender" type="radio" value="0" />Male</label>
          <label class="radio inline" style="margin-left :15px;"><input  name="gender" type="radio"  value="1" />Female</label></td>
        </tr>

        <tr>
          <td align="right">Phone :</td>
          <td><input type="tel" name="phone" value="" placeholder="My Phone No is" required />
        </tr>

        <tr>
          <td align="right">Date Of birth :</td>
          <td><input type="date" name="dob" value="" placeholder="Select Date" required /></td>
        </tr>

        <tr>
          <td align="right">Address :</td>
          <td><textarea name="address" placeholder="My complete address is" required ></textarea></td>
        </tr>

        <tr>
          <td align="right">Country :</td>
          <td>
			<div id="countryDiv">
			  <select name="country">
				<option>-SELECT-</option>
			  </select>
			</div>  <span id="loader"></span>
          </td>
        </tr>

        <tr>
          <td align="right">Prog Language :</td>
          <td>
			  <select name="lang[]" multiple="true" style="height:100px;">
				<option value="c" >C</option>
				<option value="cpp">C++</option>
				<option value="php" >PHP</option>
				<option value="chash">C#</option>
				<option value="dotnet">.NET</option>
				<option value="python" >PYTHON</option>
			  </select>
          </td>
        </tr>

        <tr>
          <td align="right">Hobbies :</td>
          <td>
            <div  style="width:450px;">
            <div style="float:left;">
              <div class="styleHobbies"><label class="radio "><input  type="checkbox" value="cricket" name="hobbies[]"/>Cricket</label></div>
              <div class="styleHobbies"><label class="radio "><input type="checkbox"  value="hockey" name="hobbies[]"/>Hockey</label></div>
              <div  class="styleHobbies"><label class="radio "><input type="checkbox"  value="football" name="hobbies[]"/>Football</label></div>
            
              <div class="styleHobbies"><label class="radio "><input type="checkbox"  value="tennis" name="hobbies[]"/>Tennis</label></div>
             
            </div>
            
            <div  style="float:left;">
				<div class="styleHobbies"><label class="radio "><input  type="checkbox"  value="carrom" name="hobbies[]"/>Carrom</label></div>
              <div class="styleHobbies"><label class="radio "><input type="checkbox"  value="bollyball" name="hobbies[]"/>Bollyball</label></div>             
			 <div class="styleHobbies"><label class="radio "><input  type="checkbox"  value="tabletennis" name="hobbies[]"/>TableTennis</label></div>
              <div class="styleHobbies"><label class="radio "><input type="checkbox"  value="others" name="hobbies[]"/>Others</label></div>
            </div>
            </div>
          </td>
        </tr>

        <tr>
          <td align="right">Image :</td>
          <td><input class="btn-large" type="file" name="image" required/></td>
        </tr>
        <tr>
          <td align="right">&nbsp;</td>
          <td><input type="submit" class="btn btn-success btn-large" value="I am done!!"/></td>
        </tr>

      </thead>

    </table>

 </form>

<!-----END INCLUDE PHP PAGES HERE ------->
            </div><!--/span-->
          </div><!--/row-->
    
        </div><!--/span-->
      </div><!--/row-->

      <hr>

      <footer>
        <p>© Company 2012</p>
      </footer>

    </div><!--/.fluid-container-->
</body></html>

